Medical Students - News and Resources

In addition to our work with K-12 students, The Yellin Center has long worked with older students in college, graduate, and professional schools. One important piece of this work is the assessment and support we have offered to approximately 100 medical students, who are often sent to us by their academic dean when they encounter difficulties with school or licensing exams, or with their "rotations" in the clinical aspects of their training.

In fact, we are delighted to announce that we have just been awarded a grant (together with the nonprofit Center for Learning Differences) from the Sergei S. Zlinkoff Fund for Medical Research and Education that will allow us to quantify the impact of our work in the assessment and remediation of these students, with a view towards providing medical educators with guidance in helping these students to achieve success in their studies and careers.

As part of our work with medical students, the Resources section of our website has information on a number of tools and apps that can help medical students with the unique demands of their professional studies. As we noted in an earlier post, this section of our website isn't always easy to locate from our home page, so we are taking the opportunity to shine a light on this helpful information. 

photo credit: University of Exeter via flickrcc

Rethinking Medical Education: Ditching Two Plus Two

Most folks would agree that the goal of education is to prepare students to successfully navigate the world after they have left school. An ever-present conundrum, though, is that no one knows exactly what that world will look like. This is especially true today, when the world, and the skill set one needs to be successful in it, is changing faster and faster. How many of today's computer science majors took computer skills classes in elementary school? Most educators could never have predicted that learning to code would put students on the fast track to success in a field that will never, it seems, stop expanding.

To prepare their students to be more effective physicians in an uncertain future, some medical schools are veering away from tradition with experimental learning models. Most medical schools still follow a model developed in the early 1900s by Abraham Flexner, a prominent educator of the time. His "two plus two" system, still prevalent  in most medical schools in the United States today, dictated that students spend two years in the classroom learning basic science and memorizing facts, then two more years in hospitals using their new knowledge in a practical setting.

Critics argue that the two plus two system no longer works. For one thing, the number of facts students must learn is growing exponentially; according to Dr. John Henning Schumann, Chair of Internal Medicine at the University of Oklahoma – Tulsa, the entire body of medical knowledge doubles every three to four years. And facts that first- and second-year medical students fought to memorize during countless caffeine-fueled study sessions may be outdated and obsolete by the time they're working with patients a few years down the road.

Additionally, ties between public health policy and medical practice are growing more and more numerous. Medical students who learn to practice their craft only within the four walls of a clinic, some believe, are missing a huge part of the equation. Social determinants (lifestyle, housing, nutrition, etc.) play an enormous role in helping to diagnose and treat a patient. Proponents of the new medical educational model argue that medical students must learn about the health care system and all of its resources to be effective, and these lessons are missing from Flexner's model.

The University of Michigan and the University of California,San Francisco are two schools experimenting with new models of medical education. One big difference is the emphasis placed on collaboration. Students work together often, since the schools' administrations are betting that teamwork will be more and more important in the future practice of medicine. And instead of simply memorizing pages of information, instructors teach students to locate current information, synthesize the facts of each case with the latest research, and act on their conclusions to provide effective care.      

At the Yellin Center, where we have been working with medical students from New York University School of Medicine and other medical training programs for years, we know that some of the most successful doctors can pair their knowledge with problem-solving skills and creative critical thinking. They collaborate readily with other medical professionals and know how to communicate clearly with patients. We look forward to learning about the kind of doctors these new educational models produce!

Photo credit: Patrick via flickr cc

Great Sources for Frontloading Videos – Part 2

Our regular readers will remember last Monday's post on this topic in which we introduced MinutePhysics and MinuteEarth as sources for frontloading videos for middle and high school students. As we explained in the previous post, frontloading is an effective instructional technique in which students are given a brief overview of a topic before learning it more thoroughly. Frontloading gives students an idea of what to expect, helps them to focus on the salient information more readily, and aids in memory.

Here are two more sources for great videos, all available free! Handwritten Tutorials will be useful to students of high-level biology and anatomy, while CrashCourse offers a broader range of courses on science, literature, and history.

Handwritten Tutorials  – high school, college, and nursing/medical school

Martin Wardle, the brainy artist behind Handwritten Tutorials, follows three guidelines as he conceives and draws up his lectures: they should be under ten minutes long, free, and enjoyable to watch. Martin has uploaded more than 75 videos in which he quickly draws all of the most important aspects of topics like anatomy, biochemistry, neuroscience, and more, narrating all the while. The explanations are easy to understand and the helpful sketches make things crystal clear. Want to take a closer look, make your own notes, or spend a bit more time studying? Students can even download the completed drawing as a PDF from the Handwritten Tutorials homepage.

CrashCourse – high school and college

Teenagers who are fans of author John Green’s quirky humor will love this channel just as much as they love his popular novels, which we have recently reviewed in our Recommended Reads series. Brothers John and Hank Green take on the task of explaining U.S. and world history, chemistry and biology, literature, ecology, and psychology on this channel, which has dedicated playlists for each topic. The videos tend to be longer, between ten to twelve minutes, because they cover more ground than the Minute videos described above. The Greens’ fast-paced delivery, visuals (comprised of diagrams, photos, maps, and animations), and joke-a-second, cerebral humor will pique adolescents’ interest in the topic before they get into the nitty-gritty of learning it in detail. There are over 100 videos to choose from.

We hope that you’re as impressed by these videos as we are! We think any of them would make a wonderful starting point for more in-depth learning.

Picmonic Uses Mnemonics to Make Science Memorable

Science, especially at the higher levels, can be especially challenging for students to learn. There’s much terminology to recall, and concepts are often so abstract that many learners struggle to keep up. Enter Picmonic (picture + mnemonic), an insightful and creative way to make seemingly arbitrary information truly memorable.

Picmonic uses an audiovisual method for teaching science. Although there is material for K-8th grader students, Picmonic specializes in medical content, making it a fantastic resource for students preparing for the MCAT or actually enrolled in medical school courses. Here’s how it works: Each concept is represented by a detailed, cartoonish picture depicting all of the important aspects. The relationship between the picture and the concept is tough to discern at first, but audio narration takes students through the different parts of the picture, explaining how each part of the image connects with real scientific concepts.

For instance, an 8th-grade-level card with a typically wacky tableau teaches about Charles Darwin and how he developed the theory of natural selection. The 80-second narration begins on the left, where a dolphin balances a cherry on its nose. “Cherry dolphin, Charles Darwin,” explains the narration. Atop the cherry is a British flag, to cue the memory that Charles Darwin was English. Next to the dolphin is an island, shaped like a golden goose. (“Golden goose, Galapagos.”) A bearded man is sitting cross legged with a book called Natural Selection on his lap. He isn’t wearing any clothes; this “natural outfit,” explains the narration, is to remind the learner that he was a naturalist. Perched in a tree above Darwin are three gray birds with thick, green beaks and a bag labeled “nuts.” On nearby islands are similar gray birds, except that the birds on one island have thin beaks that they’re using to drink from flowers and others on a separate island have pointed beaks they’re using to eat worms. A large, green monster has red plumage and a hapless bird foot protruding from its mouth, reminding learners that brightly colored birds were not adapted to the Galapagos because they were too easily spotted by predators.

All of this is explained in less than a minute and a half, and the images are so strange and memorable that it would be difficult to forget either the terminology or the concepts illustrated.

Students can select either “Classic” or “Creative” audio to explain the image to them. The creative audio sometimes takes the form of a jingle or rap and sometimes that of a narrative story with a plot. We recommend listening to both, though the creative audio seems to work best after the classic has already established the basic facts.

One aspect of the Picmonic we really like is the rating scale that appears at the bottom of each card. Once a student has learned the material, he can quantify his grasp of the concepts on a scale of one through five by indicating whether he “doesn’t know it” (1), “gets it” (5) and anywhere in between. The card will then go into a “pile” of cards with the same rating so students will know what they need to review and what they don’t.

Interested? You can try Picmonic for free to get a sense of whether this style of learning is right for you or your student. All of Picmonic’s content is available for either a monthly subscription fee or a one-time fee.

Photo credit: Flickr:  Ano Lobb

Dr. Yellin Contributes to New Book on Medical Education

We are pleased to announce the publication this week of Remediation in Medical Education: A Mid-Course Correction, featuring a chapter by Dr. Paul Yellin on "Learning Differences and Medical Education."

As many of our readers are aware, Dr. Yellin works regularly with medical students and other young adults in professional and graduate schools, helping them to deal with newly discovered or long-standing academic challenges to their academic success. In his chapter, he describes the wide range of normal variation in how medical students learn, describing both "learning variations" and "learning disabilities." He discusses various aspects of learning, which he calls "constructs" -- memory, attention, language, temporal-sequential ordering, spatial ordering, and higher order cognition -- and how difficulties in any of these constructs can impact academic success in light of the demands of medical training. He goes on to discuss the legal implications of a disability of learning and to offer strategies and resources for both medical students who struggle and their instructors.

Remediation in Medical Education edited by Adina Kalet, MD, MPH and Calvin Chou, MD, PhD (Springer, 2014), covers a wide range of issues relating to medical education, from how medical schools can provide remediation for struggling students, to how cultural issues can impede effective communication, to medical students with underlying disorders, such as autism spectrum disorders, that affect their interpersonal interactions. Both editors have worked extensively in the field of medical education and effective communication between physicians and patients.

Changes in Medical Education

Two recent articles in The New York Times focus on how medical education is changing. Both reflect the trend away from the traditional path of four years of hard science courses in college, followed by four years of medical school, where coursework continues to focus strictly on science based topics.

One move away from this is the growth in post-baccalaureate pre-med programs, where college graduates who have not taken the necessary science courses, or who are out in the working world but want to switch to a career in medicine, can prepare for medical school. According to the Times article, more than 15% of new medical students have gained admission after completing such programs and there are now 135 post-baccalaureate programs listed with the Association of American Medical Colleges (AAMC). These students may have studied poetry, history, or psychology in college and may have had work experience as teachers, artists, or marketers. They can bring a very different perspective to their medical education and their interactions with their patients.

Another trend involves changes to the medical school curriculum itself, towards what the Times piece calls "heart and soul and social science." The AAMC is making substantial changes to the Medical College Admission Test (MCAT) in an effort to look for strengths in areas other than just science, with the goal of admitting individuals to medical school who bring a broader skill set -- including the ability to connect to their patients, not just to analyze test results. Beginning in 2015, the MCAT will include sections on "Psychological, Social and Biological Foundations of Behavior" which are designed, according to the MCAT website, to recognize "the importance of socio-cultural and behavioral determinants of health and health outcomes." In addition, another new section called "Critical Analysis and Reasoning Skills" is intended to help identify applicants from diverse backgrounds. Students entering college this coming fall will be the first group to take the new MCAT when it is put in place in 2015.

Dr. Yellin's work as a consultant to the Office of Student Affairs at New York University School of Medicine and his extensive experience performing evaluations of medical students lead him to observe that whatever changes may occur to medical school admissions and curriculum, the academic demands of medical school will continue to be an issue for future physicians."Like other strong learners," he notes, "medical students will not get very far in their studies or careers without an understanding of how they actually learn and without developing a repertoire of strategies. Often, learning strategies that have worked for them in other environments don't work for them in the demanding setting of medical school. They need to develop new strategies for the extraordinary demands of the medical curriculum and that requires them to understand how they learn, since even very successful students will have stronger and weaker areas in their academic skills."

Photo: Alex Proimos/Flickr Creative Commons